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N3 GERO > lect 3: chapter 27 > Flashcards

lect 3: chapter 27 Flashcards

1
Q

what is the 5th vital sign?

A

pain

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2
Q

pain is undertreated in older adults, especially elders of color and cognitively impaired adults

A

true

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3
Q

conditions associated with neuropathic pain

A

diabetes
PVD
herpes zoster
stroke

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4
Q

conditions associated with musculoskeletal pain

A

arthritis
degenerative spinal conditions

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5
Q

examples of nonopioid analgesics

A

acetaminophen
NSAIDs (ibuprofen and naproxen)

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6
Q

what is considered the initial treatment for mild to moderate pain?

A

acetaminophen

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7
Q

what are the contraindications for acetaminophen?

A

hepatic compromise

alcoholism
malnutrition
dehydration

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8
Q

acetaminophen is most effective for osteoarthritis and back pain

A

true

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9
Q

what is the max dose for acetaminophen?

A

400mg in 24 hours

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10
Q

acetaminophen can increase the risk of bleeding when taken with warfarin

A

true

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11
Q

older adults with these conditions should not take NSAIDs

A

HTN
impaired renal function
HF

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12
Q

NSAIDs cannot be taken with which medications?

A

diuretics
ACE inhibitors
(additional kidney damage)

warfarin/ aspirin (increased bleeding)

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13
Q

NSAIDs are highly useful for which conditions?

A

persistent pain of inflammatory nature (rheumatoid arthritis)

acute inflammatory pain (muscle strain)

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14
Q

naproxen is safer than ibuprofen due to less GI complications

A

true

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15
Q

patients with heart disease cannot take naproxen

A

true
(NSAIDs are COX 1 and 2 inhibitors; it increases likelihood for MI and stroke)

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16
Q

what are COX-2 inhibitors?

A

these are gastroprotective agents that are packed alongside NSAIDs (Celebrex)

COX 2 inhibits platelet aggregation, therefore precipitates for increased GI bleeding

NSAIDs by themselves (traditional) make GI bleeding more likely, but with COX-2 inhibitor that is less likely

17
Q

COX-2 inhibitors need to be administered with this type of medication for those with higher risk of GI bleeding

A

PPI (Misoprostol)

18
Q

what is a major concern with topical pain relief?

A

rashes

19
Q

what makes opioids different from NSAIDs regarding side effects?

A

they are more predictable

20
Q

what is the only instance that would require patients to use opioids?

A

non-opioids were deemed ineffective

21
Q

common side effects of opioids

A

sedation
respiratory depression
nausea
constipation
impaired cognition

22
Q

which opioid is contraindicated in older adults?

A

demerol

(this has a strong effect that older adults are not physiologically suited for)

23
Q

there is low-risk of drug abuse when opioids are treated for pain

A

true

24
Q

how is the effect of opioids different in older adults?

A

higher peak and longer duration of action

25
Q

bowel regimen for opioid use

A

stool softener, mild laxatives, and adequate fluid intake

26
Q

what are adjuvant pain medications?

A

intended for another purpose but are useful for pain management

27
Q

types of adjuvant pain medications

A

herbs
antidepressants
anticonvulsants (Gabapentin)

28
Q

SSRIs are more effective in treating pain than most antidepressants

A

true

29
Q

older adults need a drug with shorter half lives due to

A

slower metabolism

30
Q

what are pain clinics?

A

facilities that provide specialized, and comprehensive multidisciplinary approach to pain management

31
Q

types of pain centers

A

1) syndrome-oriented
2) modality-oriented
3) comprehensive

32
Q

syndrome-oriented centers

A

focus on specific chronic problems (HA and arthritis pain)

33
Q

modality-oriented centers

A

focus on treatment techniques (relaxation or acupuncture)

34
Q

comprehensive centers

A

are associated with medical centers

includes thorough assessment of the person

utilize multidisciplinary teams

35
Q

where is aspirin better absorbed?

A

stomach

36
Q

where is morphine better absorbed?

A

intestine

37
Q

serotonin syndrome

A

neuromuscular hyperactivity

N3 GERO (19 decks)

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